One of my dear Twitter homies recently tweeted out a clip from the E! reality series WAGS, wherein the pampered ladies of the cast gleefully got IV drips of vitamins to prepare for a big party night, and facetiously asked which of her “industry homies” had done the same.

I had. I am that industry homie and she is me. I replied with some details, and our back-and-forth brought to mind all of the cosmetic procedures and off-label uses of medicines and medical equipment/procedures that I’ve either personally had or witnessed in my day. Being your industry homie as well, I’m gonna tell you what I know.

Nor are such things anyone else’s business, and I feel that no one owes anyone any explanations. At the same time, if someone volunteers information, it can be helpful for people who may not have access to the menu of services at the kind of doctor’s offices that have secret underground entrances and recovery suites that serve caviar to know a bit about what options there are out there, and the many things money can buy that might shatter some of the mystique around certain looks and behaviors. Like…

1. Getting foot injections to wear high heels

I’ve personally had foot surgery for injuries, but before that, I would get cortisone injections in my feet pretty regularly for pain management when I was dancing more. The injections themselves didn’t feel delightful, but they did the trick for the pain pretty quickly, and remember feeling the danger of doing it too often — pain relief is not the same as healing, and there’s a risk of tissue damage or exacerbating an injury because you can’t feel the pain.

I always felt that hint of danger when I was getting the injections out of medical necessity, so imagine my surprise in finding out that some women are paying for the shots as preemptive inflammatory treatment so they can wear their highest heels as much as possible.

Ultherapy is, as the official website says up front, “the ONLY FDA-cleared, non-invasive procedure that lifts and tightens the neck, chin and brow, and improves lines and wrinkles on the chest.” Also referred to as Ulthera, the device delivers heated ultrasonic energy to subcutaneous layers of the skin to stimulate the production of collagen.

Collagen is the second most abundant substance in our bodies, and the protein is an MVP, a building block for our connective tissues internally and healthy, vibrant skin externally. There are supplements people take, and a zillion collagen face creams, and nearly as many procedures meant to stimulate collagen, because at around 20 years old we start to lose the ability to make more.

This process is commonly referred to by its less scientific name of “aging,” and for some, it simply must be stopped.

Ultherapy holds the distinction of being FDA-approved, and the closest thing that exists to a non-surgical face-lift with consistent results that appear natural; that naturalness is aided by the fact that the tightening occurs through natural collagen production, which takes time. The full effects of Ultherapy can take between three and six months to be visible, making it perfect for someone who doesn’t want to look like they’ve “had work done,” but rather just have people saying they look great and not be able to pinpoint exactly why.

Like the other procedures listed here, I’ve not had CO2 myself, but I know people who have, and I’ve pursued the treatment myself. Not for my face, but for my knees — it’s popular not only for the face, but for rough areas like knees and elbows, because it can penetrate deeper than other lasers.

The fractional carbon dioxide laser can produce incredibly impressive results, although I have yet to be deemed a good candidate for the procedure because of the dangers of using lasers on darker skin, so I’ll just have to live with the cluster of scars on my knee from a nasty fall I once took that I was hoping to have vaporized.

By the way, that’s what the CO2 does — it vaporizes your skin. Once you understand that many non-surgical aesthetic procedures are about damaging your body in some way to capitalize on the body’s healing response to injury, the question then becomes how to most effectively damage it. There are chemical procedures to burn things away and varying degrees of sandpaper simulation, and lasers to do a whole bunch of stuff.

In a really fun play on words, some doctors will advertise CO2 as “not as rough on the skin,” which is hilarious if you really know what it does. It’s technically an accurate statement — completely removing something very quickly is not as rough on the thing as, say, slowly covering it in acid or grinding away at it with a sander.

CO2 removes so much skin so quickly that many doctors who perform it treat it like it’s a surgical procedure anyway, as the appearance of the areas immediately post-treatment can be pretty gruesome and require diligent aftercare to avoid compromising results. Having been in a treatment room when this was done, I can tell you it smells like burning flesh (because it is) and looks like torture porn. [I've done the Fraxel treatment myself, and I can confirm the after-effects are pretty gruesome. Give yourself about a week to heal properly, and be really careful in the sun afterward. -Dan]

It will also run you a few thousand dollars, but when that new skin grows back, most people I know who’ve had it done found it worth every penny.

4. Hair replacement

The procedure of hair replacement itself is not at all gendered, of course, but androgen hair loss is, affecting men far more than women. The latest method of hair replacement, Follicular Unit Extraction, in which individual hair follicles are transplanted one by one, has advanced far beyond the old-school hair plugs or the surgical incision–style transplants that leave a telltale scar across the back of your head.

FUE makes a teensy puncture wound to scoop out individual hair follicles from the back and then another puncture to implant them in the front/sides/thinning places. So, yes, that can mean thousands of tiny puncture wounds on your head, but they heal quickly.

I’ve seen this procedure done as well; it can take a full day and the cost will run you in the low five digits. Also, your hairs are growing back naturally from follicles, so results take months, but none of that has stopped numerous celebs from having the procedure, so the next time you do a double-take at a red carpet pic of [who cares, really, because this is not some gossipy “blind item” scenario], just know that you are NOT imagining things.

By the way, I may describe some of these procedures with a tone, but I want to say clearly that I mean no shade whatsoever to anyone who has these things done. Hey, I love my stilettos too! And who among us hasn’t bought some hair in one form or another? The differences are in means and access, and what any given person has to spend and is willing to spend in dollars, time, pain, and recovery.

I’m just pointing out that if you’re ever tempted to look at a picture in a magazine or footage from an event and think, “Hoooooow can she wear those heels all night?!” or marvel at the smooth appearance of the lady who swears up and down she’s never had any plastic surgery, it can be helpful to know how much you don’t know and keep it moving.

Not that you need to know personal specifics; again, people's appearances and bodies are no one else's business, but I talk about the procedures themselves because it's helpful to remember that we humans are perfectly imperfect and we all have flaws and get older, despite whatever visual evidence to the contrary we see in magazines.

Sure, natural beauty is a thing, and so is natural-looking plastic surgery, as well as the cavernous range of cosmetic procedures between them. Personally, I find the need to vehemently deny “going under the knife” and draw a harsh line between procedures that cut into your skin and those that don’t foolish anyway, as though only ridiculous tarts and pathetic people get plastic surgery, but having a blood facial or incredibly painful electronic “fat-melting” treatments are the most balanced and productive use of one’s time and money imaginable.

I know a brilliant cosmetic dermatologist who does what’s called a “non-surgical nose job” using only his steady hands and an impressive array of injectables, and you can find a doc offering a “non-surgical” version of quite a few procedures.

The truth is that with enough money, time, and dedication, anyone can look almost any way that they want to, so how people spend their money and how they look as a result are entirely their business. I’m just encouraging us all to avoid comparing ourselves to people when we have no idea what they may or may not have done to achieve their looks.